It happens every spring. The boots and gloves of winter are put away, and the bats and gloves of baseball come out again. But it's not all fun and games. Young baseball players are getting injured a lot more often than they used to. One study shows that elbow and shoulder injuries have increased five−fold since 2000. Youth sports injuries, particularly from baseball, were very much on the mind of orthopedic surgeons at their recent annual meeting.

Many injuries can be prevented by getting proper rest, stretching after games, not pushing young pitchers beyond their limits and cross−training.

Most of the studies presented at the meeting emphasize common sense. Many injuries can be prevented by getting proper rest, stretching after games, not pushing young pitchers beyond their limits and cross−training. Cross−training means playing a variety of sports so that no one particular muscle, ligament or tendon is constantly stressed at the expense of others. And when a player is feeling pain or injured, the proper treatment is rest. Playing with pain isn't a sign of maturity, it's a really bad life decision.

One study followed over 150 Japanese baseball players, aged 8−12, through a season. One−quarter of them complained of elbow pain. These are children, not professional athletes. Untreated elbow injuries can lead to a lifetime of pain.

Pitchers are much more likely to have arm injuries than players at other positions. The Japanese study found that over half of the players who had arm injuries were pitchers, while about one−quarter were catchers. Throwing a baseball is an unnatural arm action. Throwing a curveball or slider especially stresses the arm, and pitchers have been throwing them at ever younger ages. While coaches are becoming more sensitive to this than they used to be, young arms should not be throwing a lot of these pitches.

Charles Metzger, an orthopedic surgeon from Houston, has developed a specific five−minute stretch called the posterior capsular stretch. It helps prevent problems with one of the ligaments in the shoulder. In a study of over 1,000 players, 95% of players who did the stretches reported an improved range of motion in their throwing arm, while 65% of those who didn't do the stretches got worse over time.

The posterior capsular stretch requires two people to perform it. Instructions and diagrams for it can be found at

It is not only young baseball players whose injuries are on the rise. Injuries of young athletes in all sports, from soccer to gymnastics are rapidly rising. The main reason for this seems to be a lack of downtime. One survey found that male players aged 7−15 were playing nearly 6.5 months out of the year on average, and some were playing much longer. Even professional athletes need an off−season. How else could they make all those TV commercials?

Everyone needs some rest. Even tomorrow's superstars.

All of the studies mentioned were presented at the American Academy of Orthopaedic Surgeons' 2010 annual meeting in New Orleans.